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Navigating the Sharp Edges of Antimicrobial Resistance: An Investigative Study from Ethiopia

Antimicrobial resistance (AMR), a severe public health issue worldwide, involves the refusal of microorganisms to respond to medications that were previously effective. This resistance to antimicrobial drugs is multifaceted, with various factors contributing to its emergence. As a result, treating infections caused by resistant bacteria becomes challenging, necessitating extended treatment, resulting in severe illnesses, elevated mortality, and significant healthcare costs. Due to these implications, understanding the antimicrobial resistance profiles of bacterial pathogens is vital to optimize treatment strategies and reduce the risks associated with these infections.

An investigative survey was carried out at the Ethiopian Public Health Institute (EPHI), aimed at determining the antimicrobial resistance patterns in bacterial isolates from different clinical specimens. This study was retrospective and cross-sectional in nature and was conducted on bacterial cultures and antibiotic susceptibility reports referred to EPHI’s Bacteriology Laboratory from September 2015 to August 2019. The data extracted from 840 patients’ records included information about the type of clinical specimen cultured, bacteria type, antibiotic representations used for susceptibility testing, and the susceptibility outcomes.

The study discovered that eight types of clinical specimens were analyzed for bacterial isolates, with urine samples being the most analyzed. Ten different bacterial genera were identified by culture. E. coli showed a resistance of over 57% to seventeen antibiotics, and Klebsiella pneumonia displayed nearly 70% or more resistance rates for 17 antibiotics. Worryingly, the study reported that the overall detected multi-drug resistance (MDR) was 64.29%. The highest MDR was reported in Acinetobacter strains (84%) and Klebsiella pneumoniae (80%).

The expanded prevalence of antimicrobial resistance is primarily due to the widespread misuse and excessive use of antibiotics. Other contributory factors include poor hygiene, inadequate infection control in healthcare facilities, and antibiotic accumulation in the environment. Additionally, the use of antibiotics in the animal and food industries also significantly contributes to this problem.

Antimicrobial resistance imposes a severe threat to global health, causing an increase in disease spread, greater risk of fatalities, and escalated costs. The World Health Organisation (WHO) has identified AMR as one of the top ten global public health threats. It’s pivotal to note that tackling AMR requires a comprehensive, multi-sector approach to meet the Sustainable Development Goals laid out by WHO.

This study accentuates the urgency of strengthening antimicrobial resistance surveillance at the national level. The results also highlight that antimicrobial sensitivity testing should be readily accessible at all local diagnostic centers. The data gathered from such studies is fundamental in orienting treatment choices, identifying priority areas for intervention, and monitoring the impact of these interventions.


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